title: Differential clinical characteristics and outcome predictors of acute heart failure in elderly patients.
abstract: OBJECTIVE
  We determined the clinical-epidemiological characteristics and prognostic factors of early mortality and re-consultation in an elderly population attending the hospital emergency department (HED) for acute heart failure (AHF).
  
  
  METHODS
  A prospective, observational, non interventional study including all the patients with AHF attended in the Spanish's HED. Two groups were defined: elderly (≥ 80 years) and controls (< 80 years).
  
  
  METHODS
  demographic characteristics, comorbidity, degree of cardiac involvement, previous treatment, symptoms and signs of the AHF episode, precipitating factors, treatment in the HED and outcome.
  
  
  METHODS
  mortality and re-consultation within 30 days.
  
  
  RESULTS
  Of the 942 patients included, 455 of whom were elderly (48.3%). In this elderly population female sex, auricular fibrillation and a history of ictus and a poor functional status predominated. The type of ventricular dysfunction was unknown in 70%. No main differences in the presentation of AHF were found between the two groups. Mortality and re-consultation to the HED within 30 days were similar in both groups. While several factors were identified to be related to mortality or re-consultation in control group, in the elderly group it was more difficult to identify patients who will die or re-consult to the HED within the following 30 days. Only respiratory insufficiency on arrival to the HED was found to predict a greater probability of death (OR 3.55; CI95% 1.39-9.11).
  
  
  CONCLUSIONS
  AHF in elderly patients presents some differential characteristics and, most importantly, it is more difficult to identify which of these patients will die or re-consult in the short-term.
authors.affiliation: Area of Emergency Medicine, Hospital Universitario Central de Asturias, Emergency Medicine Investigation Group-HUCA, Oviedo, Spain. pabloherrero71@hotmail.com
authors.forename: Pablo
authors.initials: P
authors.lastname: Herrero-Puente
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Martín-Sánchez
authors.forename: María
authors.initials: M
authors.lastname: Fernández-Fernández
authors.forename: Javier
authors.initials: J
authors.lastname: Jacob
authors.forename: Pere
authors.initials: P
authors.lastname: Llorens
authors.forename: Òscar
authors.initials: Ò
authors.lastname: Miró
authors.forename: A B
authors.initials: AB
authors.lastname: Alvarez
authors.forename: M J
authors.initials: MJ
authors.lastname: Pérez-Durá
authors.forename: H
authors.initials: H
authors.lastname: Alonso
authors.forename: M
authors.initials: M
authors.lastname: Garrido
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000639:trends; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome